Sexual Aversion, Sexual Phobias and Panic Disorder

First published in 1987. The major theme of this book is that sexual aversion or sexual phobia (that is, a persistent or recurrent extreme discomfort with or avoidance of all, or almost all, genital sexual contact with a sexual partner) is more difficult to treat when accompanied by panic disorder; treatment may fail unless anti-panic medication (for example, tricyclic antidepressants or monoamine oxidase inhibitors) is prescribed and sex therapy is modified to accommodate to the special needs of these patients. Throughout the book, the author, based on her experience with 51 such cases (17 case vignettes are presented), advocates Klein's theory that patients with panic disorder suffer from a constitutional, biologic abnormality in the form of a defective or malfunctioning anxiety-regulating mechanism in the central nervous system, and their symptoms including sexual aversion represent an abnormal continuation into adult life of the protest phase of “separation anxiety.